Implementing Marketization in Public Healthcare Systems : Performing Reform in the English National Health Service

Mason, Katy and Araujo, Luis (2021) Implementing Marketization in Public Healthcare Systems : Performing Reform in the English National Health Service. British Journal of Management, 32 (2): 00. pp. 473-493. ISSN 1045-3172

[thumbnail of AAM_Implementing_Marketization_in_the_Healthcare_System]
Text (AAM_Implementing_Marketization_in_the_Healthcare_System)
AAM_Implementing_Marketization_in_the_Healthcare_System.pdf - Accepted Version
Available under License Creative Commons Attribution-NonCommercial.

Download (1MB)


To implement marketization in public healthcare systems, policymakers need to situate abstract models of prescriptive practice in complex settings. Using a performativity lens we show how policy processes bring about the changes they presume. Investigating the implementation of the Health and Social Care Act 2012, and the development of a policy instruments and Clinical Commissioning Groups, we explicate the performance of a marketization programme. This longitudinal perspective on the interactions amongst the Act’s aims, the multiple constituencies the Act attempted to enrol and the existing socio-technical arrangements the Act aimed to change, generates three core contributions. We (1) characterise the performativity of policy instruments as a process of bricolage that incorporates the principled attitude of making do on both sides of the divide – those who design the policy and those who are charged to implement it; (2) identify the mechanisms through which the performativity of an envisioned model of marketization operates at multiple scales within a complex and highly distributed system of provision; and (3) document and explicate why specific performances result in misfires and unintended outcomes. Thus, we conceptualise policy performativity as a non-linear, dynamic process where theories and their effects are constantly being assessed and reconfigured.

Item Type:
Journal Article
Journal or Publication Title:
British Journal of Management
Uncontrolled Keywords:
?? bricolagehealthcare systemsmarketizationperformativitypolicy instrumentsbusiness, management and accounting(all)strategy and managementmanagement of technology and innovation ??
ID Code:
Deposited By:
Deposited On:
15 Jun 2020 12:10
Last Modified:
17 Feb 2024 00:59